Organization
LYAM FACILITIES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMARILYS DE JESUS GOMEZ (OWNER)
(786) 223-7754
Entity
Organization
Contact information
Practice address
551 E EVANSTON CIR, FORT LAUDERDALE, FL 33312-1930
(305) 333-2659
Mailing address
551 E EVANSTON CIR, FORT LAUDERDALE, FL 33312-1930
(305) 333-2659
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/01/2021
Last updated
11/15/2021
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